La coronarographie is an exam that allows you to visualize the coronary arteries, that is, the arteries that bring blood to the heart.

This X-ray of the coronary arteries makes it possible in particular to ensure that they are not narrowed or blocked by plaques ofatherosclerosis.

Coronary CT scan or coroscanner also allows you to visualize the arteries of the heart, but in a less invasive way than coronary angiography (this requires the puncture of an artery, while the scanner only requires the perfusion of a vein to inject the contrast product) .

Coronary angiography remains the reference examination to visualize the arteries of the heart and observe any narrowing (= strictures) which can affect blood flow to the heart. These strictures can be responsible for angina, heart failure and myocardial infarction. It is more often performed than the Coroscanner, which is reserved for certain specific cases.

The indications for coronary angiography are in particular:

• The presence of pain in the chest, occurring especially during exercise (emergency or scheduled examination)
• to control and monitor coronary bypass surgery already set up
• to do a preoperative assessment in case of valvulopathie (= heart valve disease) in some patients
• to check for birth defects (congenital) of the coronary arteries.

Coronary angiography is an invasive examination which requires the puncture of an artery for the injection of an iodinated contrast product, opaque to X-rays. In practice, the doctor inserts a thin catheter in the groin (femoral artery) or of the wrist (radial artery) after local anesthesia and “pushes” it to the mouth of the right and left coronary arteries, to inject the product there in the radiology room.

The device then takes a series of pictures, while the patient remains lying down. Coronary angiography typically requires a 24 to 48 hour hospital stay, although insertion through the radial artery allows for faster patient exit.

The person is lying down, and the x-ray machine or scanner takes a series of pictures after the contrast medium is injected. This phase is painless and quick.

The examination makes it possible to highlight any narrowing or obstruction of the coronary arteries. Depending on the degree of narrowing and the patient’s symptoms, the medical team may decide to perform treatment at the same time as the coronary angiography, in order to avoid re-hospitalization.

Several options exist:

• theangioplasty : which consists of dilating the blocked artery using an inflatable balloon, with or without fitting a prosthesis (= stent, a kind of small mesh that keeps the artery open)
• le bypass (which consists of diverting circulation by avoiding the blocked artery)